Insurance reimbursement in a university-based pediatric weight management clinic
Griffith, J.; Gantz, S.; Lowry, J.; Dai, H.; Bada, H.
Journal of the National Medical Association 99(9): 1037-1041
2007
ISSN/ISBN: 0027-9684 PMID: 17913114 Document Number: 605473
To compare third-party payor reimbursement for patients evaluated in a university-based pediatric weight management clinic in central Kentucky. Demographic and reimbursement data were reviewed for 120 patients evaluated January to December 2004. Statistical analysis included Kruskal-Wallis test and Friedman's test. Overall, median reimbursement was 60%. For new appointments, contracted (56%) and capitated (60%) reimbursements were higher than Medicaid (55%). For established appointments, Medicaid reimbursement (100%) was higher than contracted (37%) and capitated (58%). Our data suggest that reimbursement is influenced by regional factors and is improving in central Kentucky.